Provider Demographics
NPI:1114321114
Name:LALWANI, MANUELLA (MCCP)
Entity Type:Individual
Prefix:
First Name:MANUELLA
Middle Name:
Last Name:LALWANI
Suffix:
Gender:F
Credentials:MCCP
Other - Prefix:
Other - First Name:ELLA
Other - Middle Name:
Other - Last Name:LALWANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1930 MARLTON PIKE E BLDG Q
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2150
Mailing Address - Country:US
Mailing Address - Phone:856-751-4127
Mailing Address - Fax:888-745-4079
Practice Address - Street 1:1930 MARLTON PIKE E BLDG Q
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2150
Practice Address - Country:US
Practice Address - Phone:856-751-4127
Practice Address - Fax:888-745-4079
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014320P101YP2500X
101YM0800X
NJ37PC00806300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00806300OtherLICENSE PROFESSIONAL COUNSELOR
PAPC014320POtherLICENSE PROFESSIONAL COUNSELOR